The Apgar score is a set of criteria used to evaluate the physical condition of a baby immediately after delivery. This system was first devised in 1952 by Dr. Virginia Apgar as a means of quickly summarizing an infant’s health. Dr. Apgar’s goal was to creat a system that would be simple to use and easily repeated. The Apgar score can be used to determine if a newborn needs emergency care or further medical assistance.
Criteria
Five factors can be added up to equal a newborn’s total Apgar score, including:
- Appearance, such as muscle tone or skin coloration
- Pulse
- Grimace response or reflex irritability
- Activity
- Respiration
This test is typically conducted between one and five minutes after the baby is born and may be repeated if the initial score is considered low. A score of zero to three is regarded as critically low, four to six is moderately low, and seven to ten is considered normal functioning. A score of ten is very rarely achieved but does not differ greatly from a score of nine.
Low Apgar Score Indications
A lower score may indicate that the infant requires medical attention but does not necessarily guarantee the baby will have long-term health issues, as the score may rise during the five-minute test. However, an Apgar score that remains below three during additional testing such as 15 or 30-minute markers is a strong indication that possible long-term neurological damage is present, as well as an increase in the risk of cerebral palsy.
It should be noted that the Apgar test was designed as a means of articulating a child’s immediate medical needs and was not intended to make long-term predictions regarding the baby’s health. External factors such as physiological maturity, medications taken by the mother, and the presence of congenital malformations can influence a baby’s Apgar score.
Neonatal Death Rates
American neonatal death rates associated with five-minute Apgar scores were:
- 0 to 3: 244 per 1,000 in term babies and 315 per 1,000 in preterm babies
- 4 to 6: 9 per 1,000 in term babies and 72 per 1,000 in preterm babies
- 7 to 10: 0.2 per 1,000 in term babies and 5 per 1,000 in preterm babies
Sources:
Apgar, Virginia. “A Proposal for a New Method of Evaluation of the Newborn Infant”. Current Research Anesthesia Analogy. 32.4 (1953): 260–267.
“Use and Abuse of the Apgar Score.” Pediatrics 98.1 (1996): 141. Academic OneFile. Web. 24 May 2012.
Pediatric Malpractice Categories and Terms
Apgar Score
The Apgar score is a set of criteria used to evaluate the physical condition of a baby immediately after delivery.
Autism
Autism is a disorder that affects brain development. This affects the mental, intellectual, as well as emotional development and health of a child.
Brachial Plexus Injury
A brachial plexus injury typically arises from complications during birth. The brachial plexus are a group of nerves located near the neck and shoulder.
Erbs Palsy
Erb’s Palsy, also known as Erb-Duchenne palsy, is the lack of arm mobility as a result of brachial plexus injury.
Birth Trauma vs Birth Defects
Birth injuries and trauma are the direct result of an adverse effect during labor and delivery and typically impair the infant’s body function or structure.
Infant Seizures
Infant seizures may indicate that there are other health problems. An infant seizure occurs as a result of brain cells “over-firing” or being excessively active.
Kernicterus
Kernicterus is a rare but serious disease that causes brain damage in infants due to increased levels of bilirubin within their blood system.
Klumpkes Palsy
Klumpke’s Palsy is a type of paralysis that affects the muscles of the hand and the forearm.
Maternal C-Section Injury
A cesarean section is also known as a C-section. It is the alternative for mothers having difficulty with vaginal birth.
Parental Rights
When hospital error or negligence results in injury or death to a newborn child, parents must exercise all their rights in order to be compensated for medical malpractice.
Pediatric Cardiology Malpractice
Pediatric cardiology is an extremely unique condition to treat, which results in unusual conditions leading to errors.
Pediatrician Negligence
Any healthcare professional who assists in the medical care of children, must have a required amount of medical skill and are required to use their skills the same way for all patients.
Pediatric Therapist Malpractice
A breach in the standard of care duty must be proven when suing a pediatric therapist for malpractice.
Stillbirth
Stillbirths are a complex medical issue and health care professionals cannot always determine the exact cause of one.
Vaginal Birth Risk
After a previous delivery via caesarean section, expectant mothers have the option of attempting a vaginal birth for their next delivery.